Medical professionals appointed to D.C.’s Board of Medicine by the mayor are expected to fully investigate complaints made against licensed physicians and other health care providers. They are to take disciplinary action if warranted.
But this peer-review process, designed to protect both the public and health care providers themselves, doesn’t work as intended when board members circle the wagons to protect their own.
That may have happened at the board’s Jan. 25 meeting, when the board refused to consider the latest in a string of complaints against a MedStar Georgetown University Hospital physician, claiming it contained no “new” information.
Attorney Roy Morris, who filed the complaint on behalf of the noncustodial mother of a Ward 3 youngster, told The Washington Examiner that the complaint did in fact contain new data never previously reviewed by the board.
The Georgetown doctor in question was already the subject of previous complaints for refusing to administer weekly doses of G-CSF — the medically accepted treatment for this child’s severe chronic neutropenia, an extremely rare and potentially fatal immune condition. But the new element in this complaint was that the same doctor had allegedly prescribed the 8-year-old girl an attention-deficit (hyperactivity) disorder drug that could make this condition worse.
The girl is listed on an international neutropenia registry, which is run by two worldwide experts who reviewed her medical records. They repeatedly warned that lack of treatment already puts her at risk for “toxic shock, loss of limbs or loss of life.”
In January, the Georgetown doctor, who characterized the girl as a “well appearing child” whose only current medical problems appear to be ADHD and asthma, listed her neutropenia only as a “prior problem.” In contrast, Morris notes, her current dental and public school health records are replete with possible symptoms of untreated neutropenia: periodontal disease, vaginal infections, lesions, delayed development, and wetting accidents.
The complaint was initially assigned to Board Chairwoman Dr. Janis Orlowski, who also serves as senior vice president of medical affairs at MedStar Washington Hospital Center. Because Georgetown is a wholly owned subsidiary of MedStar, and the complaint was against a fellow MedStar employee, one might have expected Orlowski to recuse herself. She did not. Nor did Dr. John Lynch, a bioethics professor at Georgetown University who created MedStar’s Center for Ethics program in 1982.
The D.C. Government Ethics Manual states that “An employee must not ‘participate personally and substantially’ in a ‘particular matter’ that could affect her own financial interests, or the financial interest of … any organization in which the employee serves as officer, director, trustee, general partner or employee[.]” The manual specifically states that its standards apply to “members of boards and commissions,” including those who work without pay.
As a board member, Dr. Orlowski filed the required financial disclosure statement with the D.C. Board of Elections and Ethics on May 14, 2011. Her affiliation with MedStar is not mentioned in the filing. A similar financial disclosure statement for Dr. Lynch could not be found on the city’s website. Calls to both board members for comment were not returned.
At their Jan. 25 meeting, board members reiterated their annoyance with the mother’s “unfounded” complaints, which they dismissed without review as the result of a “contentious divorce.” However, a 2010 D.C. Court of Appeals ruling found that the transference of legal custody does not remove a natural parent’s right to make “important decisions in matters having a permanent effect on the life and development of the minor.” The decision specifically mentions the administration of psychotropic medications.
After Morris threatened a lawsuit, the Board of Medicine reluctantly agreed to reconsider reviewing the complaint on its merits. It remains unknown how many other times members of the Board of Medicine have deep-sixed complaints filed against fellow employees.
The District ranked 37th among the states last year in a nationwide study of disciplinary actions taken against physicians. Perhaps this should come as no surprise.
Barbara F. Hollingsworth is The Examiner’s local opinion editor.
